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本文报道应用Olympus GIF-D可屈纤维内腔镜电灼治疗上消化道出血38例,其中胃溃疡15例,十二指肠溃疡14例,食管贲门撕裂症6例,胃体静脉曲张1例,出血性胃炎1例,食管溃疡1例。 38例均在检查时发现正在出血。检查前先用冰盐水胃内灌注,静注“安定”。内腔镜发现活动出血点后,用Cameron-Miller可屈电灼器,通过活检管直接止血。镜检发现有二种出血方式:第一种溃疡基底的凝血块下有急性旋涡式搏动性出血;第二种血管或是溃疡基底血管搏动性出血。仅2例例外,1例为胃静脉曲张,另1例有7处10毫米范围的小出血点渗出性出血。如果出血处有凝血块,用灌洗清除或电灼清除。电灼一般用4.5～5.5 Cameron-Miller电灼单位,时间为1～3秒。灼后观察几分钟,如出血完
This article reports the use of Olympus GIF-D bend fiber endoscopic vitrectomy for the treatment of upper gastrointestinal bleeding in 38 cases, including 15 cases of gastric ulcer, duodenal ulcer in 14 cases, esophageal and gastric cardial tear in 6 cases, gastric varices 1 Cases, hemorrhagic gastritis in 1 case, 1 case of esophageal ulcer. 38 cases were found in the examination is bleeding. Before the test with ice saline intragastric infusion, intravenous “stability.” Endoscopic findings of active bleeding point, the use of Cameron-Miller bendable instrument, through the biopsy tube directly to stop bleeding. Microscopic examination found that there are two kinds of bleeding: the first ulcer base clot with acute whirlpool bleeding; the second vascular or ulcerous basilar pulsatile bleeding. With only 2 exceptions, 1 had gastric varices and the other had 7 bleeding bleeds at a small bleeding point in the 10 mm range. If there is bleeding at the clot, with lavage removal or electrocautery cleared. Electrocautery with 4.5 ~ 5.5 Cameron-Miller electrocautery unit, the time is 1 to 3 seconds. Observed a few minutes after burning, such as bleeding finished